Outcome of distal clavicle resection in patients with acromioclavicular joint osteoarthritis and full-thickness rotator cuff tear

Abstract In the AMAGuides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, distal clavicle resection (resection arthroplasty of the acromioclavicular joint [ACJ]) results in ratable impairment, but only a single diagnosis within a region may be rated. Therefore, if another impairing condition is present in the shoulder region (eg, impingement syndrome or rotator cuff disease) only that resulting in the greatest causally related impairment is rated. In the setting of an occupational or other compensable injury or illness, causation of the impairment often is a key issue because, typically, only impairment that is causally related to the injury can be rated. For example, assume that a lifting injury at work caused a tear in a rotator cuff tendon that was already attenuated by repetitive impingement on inferiorly projecting spurs from longstanding degenerative arthritis of the ACJ. If surgery was performed for a traumatic rotator cuff tear and the distal clavicle also was resected due to preexisting ACJ arthritis, the latter surgery is not considered to be related to the injury. In other words, because the ACJ arthritis was neither caused nor worsened by the injury, this condition is not rated. The distal clavicular resection may have been warranted to diminish pain due to ACJ arthritis and/or eliminate the distal clavicle as a source of impingement.

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Full-thickness rotator cuff tear in rat results in distinct temporal expression of multiple proteases in tendon, muscle, and cartilage

Journal of Orthopaedic Research® ◽

10.1002/jor.24179 ◽

2018 ◽

Vol 37 (2) ◽

pp. 490-502 ◽

Cited By ~ 2

Author(s):

Elda A. Treviño ◽

Jennifer McFaline-Figueroa ◽

Robert E. Guldberg ◽

Manu O. Platt ◽

Johnna S. Temenoff

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Full Thickness ◽

Temporal Expression ◽

Cuff Tear ◽

And Cartilage

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Midterm outcome after rotator cuff reconstruction

Orvosi Hetilap ◽

10.1556/oh.2012.29352 ◽

2012 ◽

Vol 153 (17) ◽

pp. 655-661 ◽

Cited By ~ 2

Author(s):

Eszter Kővári ◽

Ádám Koteczki ◽

Balázs Kovács ◽

Péter Magyar ◽

Imre Antal ◽

...

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Ultrasound Examination ◽

Constant Score ◽

Functional Results ◽

Full Thickness ◽

Clinical Tests ◽

Cuff Tear ◽

Midterm Outcome ◽

Acromiohumeral Distance

Rotator cuff tear is a common degenerative shoulder disorder that often requires surgical treatment. However, the correlation between the size of the tear and the functional results is somewhat controversial, which generates inconsistency among orthopaedic surgeons about the indications for and methods of rotator cuff reconstruction. Aims: The aim of the authors was to evaluate the midterm functional outcome after rotator cuff reconstruction and the possible connection between the results and the surgical technique or the postoperative ultrasound examination. In addition, recently published corresponding studies are also reviewed by the authors. Methods: Twenty-seven patients with full thickness rotator cuff tear were enrolled into the study who were treated either by arthroscopic (14 patients) or by open repair (13 patients) technique. Functional results were assessed using clinical tests. Ultrasound examination was also performed. Results: The average postoperative Constant Score was 73, the average DASH (Disabilities of the arm, shoulder and hand score) was 14. The Constant scores averaged 80 for the arthroscopic and 70 for the open group. Ultrasound examination showed partial or full thickness retear of the cuff in 40% of the cases. Conclusion: More than 70% of the patients had excellent or good results two years after the reconstruction. The change in the acromiohumeral distance or partial retear failed to affect the results significantly, but full thickness tear had an effect on them. Orv. Hetil., 2012, 153, 655–661.

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A Rare Presentation of a Full-Thickness Rotator Cuff Tear With a Confluent Partial Articular-Sided Tear

Cureus ◽

10.7759/cureus.8663 ◽

2020 ◽

Author(s):

Kee-Chi Daryl Oscar O Wong ◽

Hamid Rahmatullah Bin Abd Razak ◽

Tijauw-Tjoen Denny Lie

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Full Thickness ◽

Rare Presentation ◽

Cuff Tear

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Clinical and functional outcomes of a novel transosseous device to treat rotator cuff tears: A minimum 2-year follow-up

Journal of Orthopaedic Surgery ◽

10.1177/2309499019875172 ◽

2019 ◽

Vol 27 (3) ◽

pp. 230949901987517 ◽

Cited By ~ 1

Author(s):

Mehmet Arican ◽

Yalçın Turhan ◽

Zekeriya Okan Karaduman ◽

Tacettin Ayanoğlu

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Functional Outcomes ◽

Dash Score ◽

Open Approach ◽

Full Thickness ◽

Gold Standard Method ◽

Cuff Tear ◽

The Mean

Purpose: Despite the improvements in the repair equipment techniques of rotator cuff, a gold standard method has not been defined yet and transosseous fixation through deltoid-splitting (mini-open) approach is still regarded as a good option. The primary purpose of this study is to present satisfactory clinical and functional outcomes with a novel transosseous device in full-thickness rotator cuff tear through deltoid-splitting. Materials and Methods: This retrospective study was performed on 70 consecutive patients who underwent surgery by a single surgeon from June 2014 to June 2016 for a full-thickness rotator cuff tear and was managed with a novel transosseous device. Total number of patients, mean age, percentage of male and female patients, mean duration of follow-up, percentage of involvement of the dominant extremity, affected shoulder, and tear size were recorded. Functional and clinical outcomes were assessed baseline and postoperatively at 3 and 6 months and final follow-up using Disabilities of the Arm, Shoulder and Hand (Q-DASH) and Constant-Murley scores. Results: A total of 70 (49 (70%) female, 21 (30%) male) patients whose mean age was 58.66 ± 9.19 (38–77) years were included. The mean surgery time was 35.33 ± 5.34 (28–55) min. The mean follow-up time was 28.31 ± 3.03 (24–36) months. According to the DeOrio and Cofield classification, 15 (21.43%) tears were small, 33 (47.14%) medium, 16 (22.86%) large, and 6 (8.57%) massive. By the final follow-up, the mean Constant-Murley score had significantly improved from 27.67 ± 7.46 (13–41) to 81.25 ± 3.77 (74–87; p = 0.0001) and the Q-DASH score had decreased from 82.34 ± 10.37 (65.91–100) to 10.28 ± 6.88 (0–23.45; p = 0.0001). There were no significant differences in the Constant-Murley or Q-DASH score at baseline–final follow-up between the small, medium, large, and massive tear groups ( p > 0.05). Conclusions: Treatment of full-thickness rotator cuff tear using this novel transosseous device significantly improved functional and clinical scores. However, further long-term prospective randomized multicenter trials involving comparative studies are necessary to confirm these findings.

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